Treatment of periodontal destruction associated with a cemental tear usingminimally invasive surgery

Background: A patient presented with moderate probing depth, pain on occlus al contact, and a fistula on a mandibular bicuspid. The probing depth incre ased 2 mm over a 3-month period despite relief of the occlusal trauma and r esolution of the fistula. A radiograph showed an apparent separation of the cementum in the area of the pocket. Methods: The lesion was treated using a minimally invasive surgical approac h to place a bone graft. Results: The probing depth was reduced to 2 mm with less than I mm of incre ased recession. A histologic examination of the damaged calcified tissue co nfirmed that it was cement um. Conclusions: The increasing probing depth associated with a cemental tear s eems to indicate that this phenomenon contributed to loss of attachment and bone. Removal of the detached cementum in combination with bone grafting u sing a minimally invasive surgical approach appears to have successfully co rrected the periodontal destruction.